Workers to Get Clearer Notice of Benefits Rights

Half the problem of standing up for your rights is knowing what they are. The Department of Labor is working to overhaul the information employers must give to employees about their benefits rights. The new rules, addressing things like disability and medical claims, should come early next year.

New rules to clarify benefits procedures, in some cases speed up process

Medical, Disability, Pension Claims Affected

The new rules focus on helping employees understand how to make claims under employee benefit plans. This includes the process for appealing claim denials. If you care to look at the existing regulation, you’ll see how complicated this process is. This makes getting the correct information to employees critical. The rules don’t add any additional burdens on employers other than updating their benefits notices.

This rulemaking covers some critical things like pension, medical, and disability claims. Currently, it can take up to 72 hours to get a decision on treatment for urgent medical care. This would change to 24 hours under the new rules. The Labor Department also will consider a request to change the time to appeal the denial of a pension benefit claim. Currently the employee has 60 days to file an appeal. This compares with 180 days to appeal a medical claim denial.

The basic law covering employee benefit plans is called ERISA. It’s been in place since the 1970s. Over the years new laws have tweaked ERISA’s provisions. Most recently, the landmark Patient Protection and Affordable Care Act made sweeping changes affecting health insurance, including plans offered through work. Labor’s new regulations will implement some of these changes, and also align areas not affected by the law with it.

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